Healthcare Provider Details

I. General information

NPI: 1902587470
Provider Name (Legal Business Name): VALENCIA MARIE ROLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S CENTRAL AVE STE 110
MEDFORD OR
97501-7274
US

IV. Provider business mailing address

2525 ASHLAND ST UNIT 378
ASHLAND OR
97520-1411
US

V. Phone/Fax

Practice location:
  • Phone: 541-200-5804
  • Fax:
Mailing address:
  • Phone: 541-200-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: